Abundant Peace Counseling PC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

ABUNDANT PEACE COUNSELING PC

Practice address

4141 Old Sibley Memorial Hwy
Eagan, MN 55122-1996

Phone

(612) 888-3858

Fax

(888) 425-4826

NPI assigned

Sep 16, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Michael Proebstle, MA, LPCCNPI 1205466125

Title

President

Phone

(651) 683-0000

Specialties & licenses 1

Addresses

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Proebstle, MA, LPC

  • Counselor
  • Eagan, MN
  • NPI 1205466125
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1631750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631750400000",
    "number": "1467122804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3763 DENMARK TRL W",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551231010",
            "telephone_number": "651-683-0000",
            "fax_number": "888-425-4826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4141 OLD SIBLEY MEMORIAL HWY",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551221996",
            "telephone_number": "612-888-3858",
            "fax_number": "888-425-4826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABUNDANT PEACE COUNSELING PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-16",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A",
        "authorized_official_last_name": "PROEBSTLE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-683-0000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA, LPCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michael@abundantpeacecounseling.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4141 Old Sibley Memorial Hwy",
            "city": "Eagan",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551221996",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Mental Health Counselor in Eagan, MN
• Providers in Eagan, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.